Champignonkwekerslong; klinische diagnostiek en behandeling

- The objective of this study was to give a description of the clinical picture, diagnosis and treatment in 19 patients with mushroom grower's lung. Of these patients, six worked at mushroom compost manufacturing, seven were traced by means of a nationwide enquiry among mushroom growers and six were referred by GPs. The following factors were measured after provocation at the worksite: pulmonary function, blood gas values, leukocyte count and body temperature. On the day of the provocation and on a control day chest X-rays were made.

The most frequent complaints were dyspnoea and fever (in 15 and 13 patients, respectively). Serological tests in 16 of the 19 patients revealed antibodies against various fungi that occur in locations where mushroom compost is handled. Six to 12 hours after the provocation, all patients showed a rise of the mean body temperature from 37.1 to 38.4°C; the mean leukocyte count rose from 7.7 to 17.0 x 10⁹l. Lung function studies revealed restrictive disorders: the mean VC fell from 5.15 to 4.50 l, the TLC from 6.80 to 6. 18 l. The differences, tested with Wilcoxon's two-sample test were significant (p <0.001). Roentgenological abnormalities were seen in two patients (reticular lung image).

Treatment consisted of preventive measures, such as improved air conditioning at the worksite, wearing masks, wetting the compost to keep it from flying about, and supplying pretreated compost requiring no personal preparation.